{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:35:40Z","timestamp":1792787740384,"version":"4.5.0"},"reference-count":34,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:00:00Z","timestamp":1750118400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:00:00Z","timestamp":1750118400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"American Academy of Neurology\/American Brain Foundation Neurodisparities Clinical Research Training Scholarship","id":[{"id":"https:\/\/ror.org\/00xxxe629","id-type":"ROR","asserted-by":"crossref"}]},{"name":"National Multiple Sclerosis Society Pilot Grant","award":["PP-1807-32127"],"award-info":[{"award-number":["PP-1807-32127"]}],"id":[{"id":"https:\/\/ror.org\/03019wv17","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["D43TW009340"],"award-info":[{"award-number":["D43TW009340"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["K01TW011771"],"award-info":[{"award-number":["K01TW011771"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Multiple Sclerosis International Federation Du Pre Award","id":[{"id":"https:\/\/ror.org\/052gp0981","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background\/Objectives:<\/jats:title>\n                    <jats:p>Delays to diagnosis of multiple sclerosis (MS) are largely unknown in sub-Saharan Africa. This study utilizes a quantitative approach to determine factors independently associated with delays to diagnosis among a cohort of Zambian people with MS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This cross-sectional study enrolled people with a confirmed diagnosis of MS at a public outpatient neurology clinic in Lusaka, Zambia. Standardized surveys were administered. Diagnostic delay was categorized into patient delay, health-system delay, and all delay. A multivariable linear regression model was used to determine factors independently associated with time to diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 22 participants had a confirmed diagnosis of MS. Median all delay from symptom onset to MS diagnosis was 11.4 months (interquartile range (IQR) = 4\u201335.5), with health-system delay accounting for the majority. Asian race correlated with a decrease in all delay, while evaluation outside of Zambia was associated with a decrease in patient delay and birthplace outside of Zambia correlated with decreased health-system delay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Black African people born in Zambia and evaluated in Zambia experienced prolonged diagnostic delays when compared to non-black Zambians born and\/or evaluated outside Zambia, likely due to a combination of health system and patient factors, which necessitate further study to shorten time to diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585251344832","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T02:15:16Z","timestamp":1750212916000},"page":"1039-1050","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Factors associated with delay to diagnosis of multiple sclerosis in Zambia"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1875-5679","authenticated-orcid":false,"given":"Malya","family":"Sahu","sequence":"first","affiliation":[{"name":"Department of Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA"},{"name":"University of Zambia, University Teaching Hospital, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9491-6025","authenticated-orcid":false,"given":"Mashina","family":"Chomba","sequence":"additional","affiliation":[{"name":"University of Zambia, University Teaching Hospital, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Mortel","sequence":"additional","affiliation":[{"name":"University of Zambia, University Teaching Hospital, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8493-3121","authenticated-orcid":false,"given":"Sarah","family":"Braun","sequence":"additional","affiliation":[{"name":"University of Zambia, University Teaching Hospital, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine","family":"Chishimba","sequence":"additional","affiliation":[{"name":"University of Zambia, University Teaching Hospital, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7478-013X","authenticated-orcid":false,"given":"Frighton","family":"Mutete","sequence":"additional","affiliation":[{"name":"University of Zambia, University Teaching Hospital, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4126-8970","authenticated-orcid":false,"given":"Naluca","family":"Mwendaweli","sequence":"additional","affiliation":[{"name":"University of Zambia, University Teaching Hospital, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coolwe","family":"Namangala","sequence":"additional","affiliation":[{"name":"University of Zambia, University Teaching Hospital, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley","family":"Zimba","sequence":"additional","affiliation":[{"name":"University of Zambia, University Teaching Hospital, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9297-0244","authenticated-orcid":false,"given":"Deanna","family":"Saylor","sequence":"additional","affiliation":[{"name":"University of Zambia, University Teaching Hospital, Lusaka, Zambia"},{"name":"Department of Neurology, University of North Carolina, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2013.06.015"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000768"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000150894.53961.E2"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000285102.47543.02"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000200962"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458509345913"},{"issue":"2","key":"e_1_3_3_8_2","article-title":"Multiple sclerosis in Kenya: Demographic and clinical characteristics of a registry cohort","volume":"7","author":"Jamal I","year":"2021","unstructured":"Jamal I, Shah J, Mativo P, et al. 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